| NPI | 1003886896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: PA MD419731) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NJ 25MA08143500) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: PA MD419731) | |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NJ 25MA08143500) | |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2022-01-27 |